|Melissa Rusk CLSSBB, CPC is the Director Claims and BPO Operations at SummaCare in Akron Ohio. In this role, Melissa is responsible for leading Claims, Claims Recovery, and Document Management Services. She leads and oversees multiple internal efforts to ensure compliance with federal and state regulatory requirements and plan performance guarantees. This includes: Fraud Waste and Abuse, FDR management, payment integrity, implementation of new plans and plan changes, weekly and monthly performance monitoring, system upgrades and new system implementation, encounter submissions, and plan audits. She oversees business decisions associated with coverage and payment policies.
Melissa has over 30 years’ experience working within the insurance industry in customer service, compliance and operations.
She is a Lean Six Sigma Black Belt and is certified in Lean by the University of Akron and earned her CPC designation in November 2020.